Pituitary Tumor Headaches

Pressure on or a bleed in this gland can cause head pain

Pituitary tumor headaches are caused by pressure placed on the base of the brain as this abnormal mass grows inside the gland. This symptom is common in those with such growths and takes the form of cluster headaches and migraines that can be debilitating.

In rare cases, a sudden severe headache may be a sign of pituitary apoplexy, a potentially life-threatening condition in which a blood vessel servicing the pituitary gland is either blocked or spontaneously ruptures.

This article describes why pituitary tumors cause headaches. It also explains what is involved in the diagnosis and treatment of pituitary tumors, including medical emergencies like pituitary apoplexy.

What Is the Pituitary Gland?

The pituitary gland is a hormone-producing organ situated at the base of the brain, behind the bridge of your nose. The pituitary is tasked with producing a variety of hormones vital to human function, including thyroid-stimulating hormone (TSH), luteinizing hormone (LH), growth hormone (GH), prolactin, and follicle-stimulating hormone (FSH).

Pituitary gland illustration
Stocktrek Images / Getty Images

Pituitary Tumor Growth Symptoms

Given the location of the pituitary gland, it's not surprising that headache are common in people with pituitary tumors. As a mass grows on this pea-sized gland, it compressions the structures around it, leading to head pain.

This tends to occur when a pituitary tumor is larger than 10 millimeters (0.4 inches). Other symptoms of compression caused by a pituitary tumor, which may accompany headache, include:

  • Headache
  • Visions problems like double vision and the loss of peripheral vision (due to pressure on the optic nerve)
  • Facial, sinus, or ear pain
  • Nausea and vomiting
  • A drooping eyelid

Symptoms and when they occur can vary depending on the type of pituitary tumor.

There are a variety of secreting tumors that release excessive amounts of different types of hormones, each of which can influence the symptoms someone experiences.

A non-secreting pituitary tumor may not cause symptoms until it starts to grow and compresses structures within the brain, which can take years.

Headaches and Pituitary Tumor Apoplexy

Pituitary apoplexy is when there is either a hemorrhage of the pituitary gland or the blockage of a blood vessel (infarction) servicing the pituitary gland.

In most cases, a pituitary tumor is involved. When this happens, the growing tumor can compress a blood vessel, cutting off its blood supply and causing tissues to die. In rare instances, this can lead to an ischemic stroke.

The compression may also cause the blood vessel to burst, leading in rare instances to a hemorrhagic stroke.

Symptoms of pituitary tumor apoplexy include:

  • A sudden, excruciating headache (usually at the front of the head and/or behind the eyes)
  • Nausea and vomiting
  • Paralysis of the eye muscles
  • Difficulty opening one or both eyelids
  • Loss of peripheral vision in one or both eyes
  • Double vision
  • Dizziness or fainting
  • Confusion or personality changes

If not treated immediately, pituitary apoplexy can cause permanent vision loss, seizures, and death.

Certain people are at higher risk of pituitary apoplexy, including those with uncontrolled high blood pressure, a history of heart attacks or stroke, or prior radiation treatment for head, neck, or throat cancer.

Pregnancy can also increase the risk in people with a pituitary tumor.

Diagnosis and Treatment

Pituitary tumors are typically diagnosed with a magnetic resonance imaging (MRI) scan of the brain. This uses powerful magnetic and radio waves to visualize soft tissues of the brain. Computed tomography (CT), which creates multiple X-ray images, may be useful if there has been a hemorrhage or infarction.

To identify the exact type of pituitary tumor involved, a biopsy would be performed to obtain a tissue sample.

Surgery is the most common treatment for a pituitary tumor. If the pituitary tumor is benign and in a part of the brain where the surgeon can safely operate, surgery may be the only treatment needed. 

With pituitary apoplexy, emergency treatment is needed. Surgery may help relieve pressure on the brain and improve vision symptoms. Intravenous fluids and steroids can help normalize blood pressure and relieve brain inflammation.

Long-term follow-up is needed for people with pituitary tumor apoplexy. This includes repeat MRI imaging and regular hormone blood tests.


Headaches are common with pituitary tumors as they start to grow and place pressure on structures of the brain. Headaches are often accompanied by other symptoms, such as nausea, vomiting, facial or eye pain, and vision problems.

Sudden, severe headaches can also occur with pituitary apoplexy, a medical emergency mainly caused by a pituitary tumor. With this a growing tumor can either block the flow of blood to the pituitary gland or cause the blood vessel serving the gland to break open and bleed.

1 Source
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  1. Hannoush ZC, Weiss RE. Pituitary Apoplexy. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.